Table of content for "Parenteral 50% dextrose solu" (HCPCS B4164)
General information on the “B4164” code
HCPCS Code: B4164
Long Description: Parenteral nutrition solution: carbohydrates (dextrose), 50% or less (500 ml = 1 unit) - home mix
Short Description: Parenteral 50% dextrose solu
Original information is taken from B4164 page
Pricing indicators
Pricing Indicator Code 1: 39 – Parenteral and Enteral Nutrition. Durable Medical Equipment, Prosthetics, Orthotics, Supplies And Surgical Dressings .
Multiple Pricing Indicator Code A : Not applicable as HCPCS priced under one methodology
Certification and additional reference information
Coverage Issues Manual Reference Section Number 1: 65-10
Coverage
Coverage: D – Special coverage instructions apply
Type of service
Berenson-Eggers Type of Service (BETOS): O1C – Enteral and parenteral
Type Of Service 1: E – Enteral/parenteral nutrients/supplies (eff 04/95)
Misc information
Anesthesia Base Unit Quantity: 0
Code Added Date: 19860101
Code Effective Date: 20020101
Action Code: N – No maintenance for this code